Coparentalidade e Auto-eficácia de Cuidadores de Crianças com Paralisia Cerebral

Abstract

The coparenting and self-efficacy have been pointed out as predictors of caregivers' health. This PhD thesis aimed to investigate the coparenting relationships and self-efficacy of primary caregivers of children with cerebral palsy (CP). Its structure is formed by four researches in the form of scientific articles, being a study of Systematic Review of Literature (RSL) and three empirical researches. The first RSL study was developed with the purpose of describing the existing instruments of coparenting, as well as to draw the profile of the family contexts most investigated by them. The results showed that the researches developed, dealt with coparenting exclusively through a quantitative approach, and that the available instruments were structured in the form of scales. It was possible through this study to elect the viable co-parenting instrument to be used in empirical research that would later be developed. As to the contexts investigated, it was possible to perceive that nuclear families were the most investigated contexts. These data provided the basis for furthering the objectives to be covered in the other surveys. The second and third studies were the first phase of empirical research, with the participation of 84 primary caregivers of children with CP attended at a child development Reference Center in Belém-Pará-Brazil. Data collection took place in the Center's waiting room on days when the children had scheduled appointments. The objective of the second study was to describe and analyze the coparentary relationships of caregivers based on their sociodemographic characteristics, observing possible correlations between variables, using three measures: Coparenting Questionnaire (CQ), Sociodemographic Inventory (ISD) and Gross Motor Function Classification System (GMFCS). Data analysis showed caregivers with low level of co-parenting, associated with the gender and age of the children, the fact that they did not attend school, and higher levels of motor impairment. In the same way, it was verified that the civil status and the religion of the caregivers, the income and the family structure, influenced their coparenting relationships. Through the use of the aforementioned instruments, plus a self-efficacy scale, the third study was developed with the purpose of describing and analyzing, in addition to the coparenting relationships, the level of parental self-efficacy of the participants, showing which care behaviors feel more self-efficacious. The data showed that the caregivers, in addition to the low level of coparenting, also, for the most part, demonstrated a low level of self-efficacy. As for the aspects for which they were self-efficacious, those related to routine childcare were the main ones. Among those who showed less self-efficacy were the clinical aspects of children, such as the occurrence of seizures. No statistically significant associations were found between general coparenting scores and self-efficacy. The fourth study consists of a quanti-qualitative mixed research, consisting of two phases, in which the first one involved 84 caregivers and in the second, nine coparental dyads. Data were collected through the application of CQ in the first phase and semi-open interviews conducted in the caregivers' homes, with the objective of analyzing their perception about their coparenting relationships, and their speeches were analyzed through content analysis. The Principal Components Analysis technique was applied to data from CQ, which were answered only by the mothers during the first collection phase. Through three proposed levels of coparenting (positive, average and negative), it was observed that two dyads presented positive coparenting, whose main factor was the high cooperation in the division of care for children with CP and the high quality of their marital relationships. Five dyads were classified with average coparenting. In this, in addition to cooperation observed in the dyads, conflicts were verified. Two dyads presented negative coparenting, associated with the existence of coparental and conjugal conflict, and total maternal dissatisfaction. The data showed the lack of studies in the area (study 1), it was noticed that the context of socioeconomic vulnerability and the low quality of the conjugal relationship is associated to the low level of coparenting of the caregivers (study 2 and 4), in the same way that Perceived caregivers with low perceptions about their parental self-efficacy when faced with an extreme situation such as coping with a seizure (study 3). At the end of this thesis, it is expected that the data presented here contribute to the clarification about the coparenting relationships as well as the parentalself-efficacy.